| NPI | 1790922920 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOBY BARNETT Chief Fin Officer 573-632-0243 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2009-01-09 |
| Last Update Date | 2016-03-10 |